Combination with local and oral use of Steroid successfully prevented stricture after complete circular endoscopic submucosal dissection (ESD) for superficial esophageal cancer

Abstract

Patient was a 50-year-old man with anemia and high CEA. Esophagogastroduodenoscopy (EGD) showed a 0-IIb lesion in the middle thoracic esophagus. Narrow band imaging (NBI) revealed a brownish area, and magnifying endoscopy with NBI showed an intrapapillary capillary loop with mild dilation. After iodine spraying, the lesion showed partial circularity. Whole-body contrast CT showed no metastasis. Lesion was removed by ESD on post admission day (PAD) 1. 100mg triamcinolone acetonide (TA) was injected to the resected site to prevent postoperative stricture. Oral prednisolone (PSL) 20mg/day was started from PAD 2 and decreased to 10mg/day within 2 weeks after ESD. EGD was done bi-weekly, with confirmation of healing on PAD 68. PSL was finally stopped on PAD 89. No postoperative stricture was observed during follow up.